On the morning of July 12, Zeng Chengjie, a businessman and real estate developer from China’s Hunan Province, was executed by firing squad. Mr. Zeng, 55, was convicted of illegal fundraising involving 3.4 billion yuan ($550 million). His daughter, Zeng Shan, later protested on Weibo, China’s Twitter, that the court had not notified the family before her father’s execution. It was a full two days after his death that the Zeng family finally received the execution notice by mail. Postmarked “July 13,” the notice was issued on July 12, the day of Zeng’s execution.

The hasty and secretive execution prompted suspicions among Weibo users. Many in particular have questioned whether or not authorities harvested Zeng’s organs for use in transplant operations. The government cremated Zeng and did not disclose the record of events surrounding his execution, so there is no way to know what happened to Zeng’s body. Nonetheless, the practice of using executed prisoners’ organs for transplantation is an open secret in China.

Huang Jiefu, who served as vice minister of China’s Ministry of Health for 12 years and was in charge of China’s organ transplant development until stepping down in March, has admitted on various occasions that the majority of organs used for transplantation in China come from executed prisoners. A March 2012 article co-authored by Huang in a major medical journal, The Lancet, asserted that “65% of transplantation operations done in China use organs from deceased donors, over 90% of whom were executed prisoners.” But the Chinese government has long held that the use of any organ from a prisoner only occurs after full consent from the prisoner, including families when appropriate.

This March, after a three-year trial run, the Ministry of Health and the Chinese Red Cross launched a nation-wide organ donation system, similar to the United States’ United Network for Organ Sharing. During the program’s trial period, of the 164 transplant hospitals that participated, only 659 people donated a total of 1,804 major organs, while organs donated by executed prisoners are several times greater. If prisoners indeed always provided consent prior to donating organs, as the Ministry of Health has claimed, then death row inmates are extraordinarily more likely than the general population to donate. This is implausible.

Recent Chinese reporting shows that low confidence in a system seen as opaque and unfair is a major deterrent for potential organ donors in China. Earlier this month, the Chinese media reported that hospitals in China’s Jiangsu and Guangdong provinces were being asked by their local branches of the Chinese Red Cross to pay RMB 100,000 ($16,300) for each successful organ donation organized by them. It is no wonder then, that in a separate article, when a young Chinese person was asked by a newspaper in Beijing about whether or not she would consider being a donor, she responded, “I am not sure whether the organs will be used on the people who need them.”

The Chinese government has vowed to reduce dependence on executed prisoners for organ transplants. Earlier this year, former vice minister Huang projected that in two years’ time, China’s organ transplant system will no longer rely on executed prisoners. With low public trust in the government-run organ donation system, it is unclear whether the Chinese government will be able to meet its goal.

But things are seen as changing for the better. Doctors across the country agree that the supply of organs for transplant is growing increasingly scarce, the result of decreasing executions and more stringently enforced consent requirements. Chief physician of the organ transplant department in Hubei Province’s Tongji Hospital, Dr. Chen Gang, has said that written consent of death row inmates is now required because of human rights concerns voiced by the international community. According to a professor in China who wished to remain anonymous, pressure from the public at large is a major factor. “If the deed is leaked and there is a public outcry,” the professor commented, “someone has to come forward and take the blame. Hospitals and doctors are the easy target. Fewer are willing to take the risk.”

Although China has made strides in recent years, the reality of organ harvesting from unwilling donors persists. Executions done behind closed doors and without notifying family, like Zeng’s, perpetuate suspicion of dubious organ transplantation practices.